THE ETHICO LEGAL ASPECTS OF IV THERAPY BASIC

DUTIES AND RESPONSIBILITIES OF IV THERAPISTS

1. Interpret and carry out the physicians prescriptions for IV therapy. 2. Prepare, initiate and terminate IV therapy based on physicians written prescription. 3. Perform peripheral venipuncture (all types of needles and cannulas e!cludin" the insertion of subclavian and cut down catheter.

#. $etermine solution and medication incompatibilities. %. &dminister computed medications, chemotherapeutic dru"s, flow rates of solutions, compatible blood'blood components and parenteral nutrition as prescribed by the physician.

(. &ssess all adverse reactions related to IV therapy and initiate appropriate nursin" interventions. ). *stablish nursin" care plan related to IV +herapy. ,. &dhere to established infection control practices.

-. .aintain proper care of IV e/uipments. 10. $ocument relevant data in the preparation, administration and termination of all forms of IV therapy.

LEGAL BASIS

IV THERAPY AND LEGAL IMPLICATIONS R.A. 7164 1 +he Philippine 2ursin" &ct of 1--1 3ection 2, states that in administration of IV in4ections, special trainin" shall be re/uired. IV 2ursin" 3tandards of Practice developed by the &23&P should be used.

In "ivin" IV in4ections, nurses should follow the policies of their a"encies. 5oard of 2ursin" 6esolution 2o., 3ec.30 (c &rt.VII or administratively under 3ec.21 &rt.III 1 states that any re"istered nurse without trainin" and who administers IV in4ections to patients shall be held liable, either criminally, administratively or both.

 6.&. -1)3'+he Philippine 2ursin" &ct of 2002, &rticle VI 2ursin" Practice, 3*7.2,.3cope of 2ursin" (a Provide nursin" care throu"h the utili8ation of the nursin" process. 2ursin" care includes, but not limited to9 administration of written presentation for treatment, therapies, oral, topical and parenteral medications9

+hat in the practice of nursin" in all settin"s, the nurse is duty: bound to observe the 7ode of *thics for nurses and uphold the standards of safe nursin" practice.

ETHICAL ISSUES

CODE OF ETHICS FOR NURSES IN THE PHILIPPINES

*+;I73 accordin" to <ebster $ictionary, is the study of the standards of conduct and moral 4ud"ment. +herefore.. 2=63I2> *+;I73 is concerned with the principles of ri"ht conduct as they apply to the nursin" profession.

NURSES AND PEOPLE

? Values, customs and spiritual beliefs held by individuals are to be respected. ? 2urses hold in strict confidence personal information ac/uired in the process of "ivin" nursin" care.

NURSES AND PRACTICES ? 2urses are accountable for their own nursin" practice. ? 2urses maintain or modify standards of practice within the reality of any "iven situation.

? 2urses are the advocates of the patients. ? 2urses are aware that their actions have professional, ethical, moral and le"al dimensions.

NURSES AND CO-WORKERS

? 2urses maintain collaborative wor@in" relationships with their co:wor@ers and other members of the health team. ? +hey reco"ni8e their capabilities and limitations in acceptin" responsibilities and those of their co:wor@ers when dele"atin" responsibilities to them.

NURSES AND SOCIETY ? 2urses are contributin" members of society. +hey assume responsibilities inherent in bein" members and citi8ens of the community'society in which they live'wor@.

? 2urses reco"ni8e the need for chan"e and initiate, participate, and support activities to meet the health and social needs of the people.

NURSES AND THE PROFESSION ? 2urses are e!pected to be members of professional or"ani8ations of nurses. ? 2urses help to determine and implement desirable standards of nursin" practice and nursin" education.

? 2urses should initiate and involve themselves in structured and non: structured research activities within their e!istin" milieu. ? 2urses should assert the implementation of labor standards and lobby for favorable le"islations to improve e!istin" socio:economic conditions of nurses.

CODE OF ETHICS Th N!"#$%& S "'$( A)*$%$#+",+-"# -. +h Ph$/$00$% #

MISSION
Provision of efficient and effective nursin" services. Promote /uality health care for people as a basic human ri"ht. 5e responsible for plannin", or"ani8in", directin" and controllin" the pro"rams and activities of the 2ursin" 3ervice towards optimum /uality nursin" care.

ARTICLE II
THE ANSAP CREED1 CORE VALUES 2 BELIEFS 1. +he nursin" profession is a commitment to >od and peopleA 2. +he nursin" service is responsible and accountable for /uality nursin" careA

3. +he nursin" service is a ma4or function in any health care delivery system and deserves a correspondin" importance in the or"ani8ational structureA #. & hi"h level of self:discipline and committed leadership are essential factors in the effective mana"ement of health care servicesA

%. +he nursin" services is most important asset, aside from its clients, are its carin", competent and productive personnelA (. 7ompetence enhances the publics assurance of /uality nursin" care, therefore, nursin" personnel must be selected and appointed to positions consistent with their /ualificationsA

). +he client is the reason for the e!istence of the nursin" professionA all efforts should be directed to his care and should consider his uni/ueness, personal worth, di"nity, and socio:cultural valuesA ,. +he implementation and maintenance of approved standards of nursin" practice and nursin" administration are bases for effective and efficient nursin" serviceA

-. 2ursin" service is inte"ral in the /uality of education of studentsA and 10. & unified stand is vital in achievin" their ob4ectives throu"h membership in professional or"ani8ations, such as the Philippine 2urses &ssociation (P2& , the &ssociation of 2ursin" 3ervice &dministrators of the Philippines (&23&P , and other specialty "roups in nursin".

ARTICLE III
NORMS OF PROFESSIONAL CONDUCT 3*7+IB2 1. $edication to >od and people. 3*7+IB2 2. 6esponsibility and accountability for /uality nursin" service.

3*7+IB2 3. Ceadership and +echnical 7ompetence. 3*7+IB2 #. 6esponsibility and &ccountability for 2ursin" Practice. 3*7+IB2 %. 7ommitment to the 2ursin" Profession.

ARTICLE IV
GENERAL PROVISIONS 3ection 1. 7reation of *thics 7ommittee that shall be responsible to ad4udicate violations a"ainst the 23& 7ode of *thics and adopt such rules and sanctions as the association is authori8ed to do.

3*7+IB2 2. Ce"al Dorce. 3*7+IB2 3. .oral Dorce. 3*7+IB2 #. $issemination.

3*7+IB2 %. 3anctions. 3*7+IB2 (. &mendment. 3*7+IB2 ). *ffectivity

CODE OF GOOD GOVERNANCE FOR THE PROFESSIONS IN THE PHILIPPINES

? E.O. N-. 334 - $irectin" the adoption of the 7ode of >ood >overnance for the Professions in the Philippines on Eune 23, 2003.

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Professionals are re/uired not only to have an ethical commitment, a personal resolve to act ethically, but also have both ethical awareness and ethical competency.

S0 ($.$( P"$%($0/ # -. P"-. ##$-%,/ C-%)!(+ 1. 3ervice to Bthers 2. Inte"rity and Bb4ectivity 3. Professional 7ompetence #. 3olidarity and +eamwor@

%. 3ocial and 7ivic 6esponsibility (. >lobal 7ompetitiveness ). */uality of &ll Professions

PROFESSIONAL VALUES

CARING
is the locus of all attributes used to describe 2=63I2>. It is not only the main value of 2=63I2> but the *ssence. It is not only a nursin" act because to care is human and to be human is carin".

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RELATED LAW OFFENSES

LEGAL ASPECTS AND THE NURSE +he 6epublic &ct -1)3 or the Philippine 2ursin" &ct of 2002 is the best "uide the nurse can utili8e as it defines the scope of nursin" practice.

N &/$& %(
7ommission or omission of an act, pursuant to a duty, that a reasonably prudent person in the same or similar circumstance would or would not do.

Th D-(+"$% -. R # I0#, L-9!$+!" +hree conditions are re/uired to establish a defendants ne"li"ence without provin" specific conductG 1. +hat the in4ury was of such nature that it would not normally occur unless there was a ne"li"ent act on the part of someoneA

2. +hat the in4ury was caused by an a"ency within control of defendantA 3. +hat the plaintiff himself did not en"a"e in any manner that would tend to brin" about the in4ury.

*!ampleG & patient came in wal@in" to the out:patient clinic for in4ection. =pon administerin" the in4ection to his buttoc@s, the patient e!perienced e!treme pain. ;is le" felt wea@ and he was subse/uently paraly8ed.

M,/0",(+$(
6efers to a ne"li"ent act committed in the course of professional performance. *!ample is the "ivin" of anesthesia by a nurse or prescribin" medicines.

I%(-*0 + %(
+he lac@ of ability, le"al /ualifications or fitness to dischar"e the re/uired duty. *!ampleG &lthou"h a nurse is re"istered, if shes not yet an IV therapists, she is not allowed to "ive IV medications or do the IV insertion.

A##,!/+ ,%) B,++ "7

&ssault is the imminent threat of harmful or offensive bodily contact. 5attery is an intentional, un consented touchin" of another person.

It is, therefore, important that before a patient can be touched, e!amined, treated or sub4ected to medical'sur"ical procedures, he must have "iven a consent to this effect. *!ampleG If a patient refuses an in4ection and the nurse "ives it anyway, the latter can be char"ed for battery.

LEGAL TERMINOLOGIES THAT ALSO APPLY IN IV THERAPY

? CIVIL ACTION
a non:criminal action whereby one see@s to protect, enforce, or declare a ri"ht or address a civil wron" close to him or her. <hen the harm occurs, the "uilty party may be re/uired to pay dama"es to the in4ured person.

? CRIMINAL ACTION
an action brou"ht about by a state or federal law enforcement a"ency or by an official a"ency on behalf of an individual, to protect ones person or property or to protect society in "eneral. Punishment includes imprisonment, fine or both.

? DEPOSITION
a discovery procedure which is an oral /uestion and answer proceedin", under oath and recorded, wherein the attorneys see@ to find out what testimony and evidence will be confrontin" them in a lawsuit. It is an informal proceedin" with lawyers of all parties present.

? INTERROGATORY
another discovery procedure which is the written e/uivalent of a deposition.

? RULE OF PERSONAL LIABILITY

every person is liable for his own wron"doin". 2o one can bypass this rule with personal assurance.

? STATUTE OF LIMITATIONS
the time limit set by each state le"islature in which civil or criminal action can be brou"ht.

? TORT
a private wron" by act or omission, which can result in a civil action by the harmed person.

? SUBPOENA
the process or Hpaper commandH by which the person served must appear at a certain time and "ive testimony to the court. It is an order under the seal of the court for which one can be held for contempt of court for i"norin" the subpoena.

? SUMMONS
notification served upon defendant to appear before the court.

NURSING LIABILITIES AND PREVENTIVE MEASURES

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1. 5e very familiar with the Philippine 2ursin" Caw. 2. 5eware of laws that affect nursin" practice. 3. &t the start of employment, "et a copy of your 4ob description, the a"encys rules, re"ulations and policies.

#. =p"rade your s@ills and competence. %. &ccept only such responsibility that is within the scope of your employment and your 4ob description. (. $o not dele"ate your responsibility to others.

). $evelop "ood interpersonal relationships with your co:wor@ers, whether they be your supervisors, peers or subordinates. ,. 7onsult your superiors for problems that may be too bi" for you to handle. -. Verify $octors prescriptions that are not clear to you or those that seem to be erroneous.

10. +he doctors should be informed about the patients conditions. 11. Feep in mind the value and necessity of @eepin" complete and accurate recordin". 12. Patients are entitled to an informed consent.

STANDARDS OF NURSING INFUSION CARE

RE6UIREMENTS TO BECOME AN IV THERAPIST

S+"!(+!" C"$+ "$, :NOT INCLUDED;

1. *ntrance 6e/uirements Cevel of academic preparationG & 532 "raduate, 62, with a current license from the P67. 5ehavioral characteristics G ;onesty, reliability, initiative, fle!ibility and 4ud"ment.

 $emonstrates communication and technical s@ills. 2. 7ompletion 6e/uirements 3 days 5asic IV +herapy +rainin" Pro"ram must have successfully participated.

3. 6enewal'6evalidation of an IV +herapy 7ard +he IV +herapy 7ard is renewable every three (3 years. &ttendance to IV related =pdates e/uivalent to 2# 7*=.

#. Coss of +he IV +herapy 2urse 7ard Presentin" an affidavit of loss. 3ubmittin" 7ertificate of +rainin". Photocopy of the official list of participants of the IV therapy trainin" attended.

%. 7ancellation of the IV 7ard P67 Cicense is not renewed. &ny violation of 2ursin" Caw -1)3. IV 7ard is not renewed for more than 3 years. Violations in the 3tandards of IV +herapy practice.

P"-( ## C"$+ "$,:NOT INCLUDED;

+he IV +herapy Pro"ram consists of discussions of concepts in IV therapy and demonstration of s@ills in access:related situations. It has a twenty:four (2# :hour didactic lecture and a practicum with the followin" evaluation methodsG

1. <ritten e!aminationsG pre and post tests 2. 7ompletion of the re/uired number of actual cases for each of the followin" competenciesG Initiatin" and maintainin" peripheral IV infusion (3 cases . &dministerin" IV dru"s (3 cases

 &dministerin" and maintainin" blood and blood components (2 cases . +he participants will be rated as followsG (a $idactic 1 %0IA and (b Practicum 1 %0I.

REFERENCES
? Association of Nursing Service Administrators of the Philippines, Inc. (ANSAP). 2000. Nursing Standards on Intravenous Practice 7th !I"I#N. Att$. %ustico ". !e &elen, &A, &SN, ''&, (NSA, Ph! and !onna )ivian ). !e &elen, &SN, %N, **%N, *%NA, (S Anesthesia. Nursing 'a+, ,urisprudence - Professional thics .st !I"I#N.

? ? ? ?

'esni/, (.,. and Anderson, &. Nursing Practice and the 'a+. 2nd !I"I#N +ith revisions. Philadelphia0 ,.&. 'ippincott. Palloc/0 "orts, .1th !I"I#N. Philippine Nursing Act of .22., %epu3lic Act No.7.42 Sec.25. Philippine Nursing 'a+, %epu3lic Act No. 2.76 Section 25 (a), (e). Prescer0 "orts, 6rd !I"I#N.

? ?

P%I( % *#! #7 "8I*S "8 N9%SIN: S %)I* A!(INIS"%A"#%S #7 "8 P8I'IPPIN S. Professional %egulation *ommission, &oard of Nursing %esolution No. ,. Professional %egulation *ommission &oard of Nursing Souvenir Program #ath ta/ing as Professionals of the Successful ;aminees ,une 4 - 7, 2001 Nurse 'icensure ;amination.

)en<on, '$dia (. %.N., (.A., 7P*8A. 2006. Professional Nursing in the Philippines 2th !I"I#N . =e3ster>s Ne+ =orld !ictionar$ of the American 'anguage. *leveland and Ne+ ?or/0 =orld Pu3lishing *o.